Cases reported "Trauma, Nervous System"

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1/21. median nerve damage from brachial artery puncture: a case report.

    This report describes a case in which puncture of the brachial artery to obtain a sample for blood-gas analysis resulted in damage to the median nerve with a persisting neuropathy and apparent loss of function. Errors in judgment and contributions to possible negligence included (1) inappropriate choice of sampling site; (2) lack of knowledge of precautions and possible complications; (3) incomplete/inadequate description of optimal procedure in departmental procedure manual; (4) arbitrary selection of the dominant hand. ( info)

2/21. Four-level noncontiguous fracture of the vertebral column: a case report.

    The case of a patient with four-level fractures of the vertebral column, located at the cervical, thoracic, lumbar, and sacral regions, three of which were unstable, is reported. There were no injuries in the appendicular skeleton. Neurological involvement was potentially caused by multilevel compressions. This patient was treated aggressively with early surgical stabilization of all unstable levels, which facilitated early expeditious rehabilitation. ( info)

3/21. Bilateral multiple cervical root avulsions without skeletal or ligamentous damage resulting from blast injury: case report.

    OBJECTIVE AND IMPORTANCE: We describe a unique case of multiple bilateral cervical root injuries without ligamentous or bony injury secondary to a sandblast accident. CLINICAL PRESENTATION: A 19-year-old man sustained a sandblast injury to his face, neck, chest, and upper extremities, with immediate loss of motor and sensory function occurring in both of his upper extremities. Cervical spine x-rays, computed tomography, and magnetic resonance imaging demonstrated no fracture, soft tissue abnormality, or malalignment. The restriction of deficits to the patient's upper extremities suggested a central cervical spinal cord injury, bilateral brachial injuries, or a conversion disorder. INTERVENTION: Cervical computed tomographic myelography revealed multiple bilateral nerve root injuries. CONCLUSION: This case report is unique in the literature in that it describes a patient with multiple cervical nerve root injuries secondary to sandblast injury without ligamentous or bony injury. Although magnetic resonance imaging remains the diagnostic modality of choice in patients with acute spinal cord injury, it is deficient in demonstrating cervical root injury in the acute setting. In this setting, computed tomographic myelography is superior. ( info)

4/21. The neurological complications of electrical injury: a nursing case management perspective.

    High-energy electrical injury, whether from lightning strike or electrical shock, occurs primarily in the workplace. Neurological dysfunction can be a devastating complication of electrical injury. A review of the literature was undertaken to develop a better understanding of the epidemiology, mechanisms of injury and neuropathology associated with this type of injury. The numerous challenges inherent in the management of these complex cases were illustrated by three case studies. ( info)

5/21. Circumferential fracture of the skull base causing craniocervical dislocation. Case report.

    Fractures of the craniocervical junction are common in victims of high-speed motor vehicle accidents; indeed, injury to this area is often fatal. The authors present the unusual case of a young woman who sustained a circumferential fracture of the craniocervical junction. Despite significant trauma to this area, she suffered remarkably minor neurological impairment and made an excellent recovery. Her injuries, treatment, and outcome, as well as a review of the literature with regard to injuries at the craniocervical junction, are discussed. ( info)

6/21. How safe is blood sampling? Anterior interosseus nerve injury by venepuncture.

    All invasive procedures carry some degree of risk of damage to the normal structures in the proximity of the region where the procedure is performed. The risk is, however, minimal for venous cannulation. A case is reported of an injury to the anterior interosseus nerve sustained during venepunture for routine blood sampling at the cubital fossa. ( info)

7/21. lightning injuries.

    Lightning strikes may cause a constellation of injuries. Blunt head trauma, neurologic injury, and cardiac injury are common in these patients. In contrast to high-voltage electrocutions, blunt trauma after a lightning strike is common. Thorough evaluation of all organ systems is crucial. This report discusses mechanism of injury and describes initial evaluation and treatment of lightning strike victims. ( info)

8/21. Neurologist as expert witness.

    Prevailing liberal rules of evidence permit qualified medical and scientific experts to offer opinions designed to help courts decide issues to which their expertise relates. The opinions can be based on direct examinations, review of data assembled by others and data or inferences of a type relied on by other experts in the field. Application of these rules is illustrated through analysis of expert testimony in litigation involving a neurologic syndrome allegedly caused by an immunization and in a case involving controversy over the extent and outcome of major brain injury. Concerns about misuse of expert medical and scientific testimony in litigation are addressed. The article closes with a consideration of approaches designed to improve the reliability of expert testimony. ( info)

9/21. Injury to the deep branch of the ulnar nerve in association with dislocated fractures of metacarpals II-IV.

    The deep branch of the ulnar nerve may be injured at the same time as fracture dislocations of the fifth metacarpal. We describe injuries to that nerve in two patients with dislocated fractures of the second or third and fourth metacarpals. The fractures were treated by open reduction and fixation with plates and screws, and it is possible that the repositioning and fixing caused the injury. ( info)

10/21. The prevention of nerve injury in aortic arch aneurysmal surgery.

    In a case of aortic arch aneurysm associated with adhesion to the surrounding structures, we devised an operative technique to avoid nerve injury during the surgical procedure. By preserving the adventitial layer of the aortic arch aneurysm to which the phrenic and recurrent nerves were attached, injury to the nerves was avoided, and the aneurysmectomy was completed with the distal anastomosis being performed intraluminally. ( info)
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